This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.

The Register’s Editorial: Why tie insurance to jobs?

By the Editorial BoardThe Des Moines Register, August 27, 2013

In many households, one spouse buys health insurance through a job for the entire family. Now United Parcel Service Inc. has announced it intends to cut this coverage for working spouses of nonunion employees next year.

A UPS spokesman said the change is necessary to keep costs down.

Denying insurance to workers’ spouses will certainly create a financial burden for families, particularly if companies don’t reduce the premiums for workers when they implement such a change. Now the family needs to purchase two policies to cover both adults in the home. Also, the health insurance offered by the spouse’s employer may not cover needed services or may impose higher co-payments and deductibles.

Unfortunately, this is how things work in a country that has tied health insurance to employment. We have long recognized that is a bad idea. Your employer doesn’t select and subsidize your homeowner’s insurance or your car insurance.

The practice burdens U.S. businesses and puts them at a disadvantage in a global economy. In other countries, the government facilitates coverage for everyone.

Employer-based health insurance creates problems for workers. They are at the mercy of their company when it comes to which plans are available.

In some ways, the health reform law addresses some of these problems.

Yet the Affordable Care Act is built on a broken system. As the Register’s editorial board wrote for years prior to the passage of the health law in 2010, this country needs a single-payer health care system with coverage facilitated by the government. Similar to Medicare, everyone could contribute through taxation and everyone would be covered. Instead of such a change, Congress cemented in place the practice of tying health insurance to jobs by requiring many companies to offer it.

The long term result will likely be more companies doing exactly what UPS is doing.

We already knew that The Des Moines Register held an editorial position in favor of single payer reform, but this reiteration of their position is highly significant.

Much of the activity in support of single payer has faded as attention has turned to implementation of the Affordable Care Act. The prevailing attitude is that, well, we tried and this is the best that we could get. We can work on trying to patch this system, but forget trying to negotiate the major barriers erected by obdurate politicians. Even if current laws and regulations have locked up much of the nation’s health care funds, we’ll just try to muddle our way through with incremental steps using some future form of magical waivers which we will need since the currently available waivers, including those in the Affordable Care Act, cannot change the basics of the fundamentally flawed, fragmented infrastructure of multiple public programs and private plans, or no plans at all for far too many of us.

What is so important about today’s message is that the Register’s editorial board sees through this nonsense. “The Affordable Care Act is built on a broken system.” Congress has “cemented” into place this highly dysfunctional infrastructure. Incremental steps cannot work when we are heading down the wrong pathway.

As the Register states, “This country needs a single-payer health care system with coverage facilitated by the government – similar to Medicare, everyone could contribute through taxation and everyone would be covered.”

The Des Moines Register is back on message. We have to get back on message as well.

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Physicians for a National Health Program's blog serves to facilitate communication among physicians and the public. The views presented on this blog are those of the individual authors and do not necessarily represent the views of PNHP.